| NPI | 1083693527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 33385) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 33385) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-03-30 |