| NPI | 1083029763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 282644) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 23134) |
| Enumeration Date | 2014-06-22 |
| Last Update Date | 2023-02-09 |