| NPI | 1053816462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A165900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0101438) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-08-08 |