| NPI | 1073006318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2022-02655) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35C.003813) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2026-05-07 |