| NPI | 1043570757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E9850) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 29173) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2020-10-26 |