| NPI | 1043621055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A154817) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 262825) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-09-20 |