| NPI | 1033290010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 79038) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D23417) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2023-02-16 |