| NPI | 1073587952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME127547) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101038183) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-04-26 |