| NPI | 1033679840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A187813) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 11899046-1205) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-04-04 |