| NPI | 1063518066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 44014) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM 2002-0264) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-12-10 |