| NPI | 1063579886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 17272) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: RI MD07090) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-03-07 |