| NPI | 1073288536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 9271) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 34074) |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL 34074) | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2022-07-27 |