| NPI | 1073772398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 30196) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD445114) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2020-08-04 |