| NPI | 1033157623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 201701307) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2004033186) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-04-27 |