| NPI | 1124077359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 65583) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 28562) |
| 207W00000X Ophthalmology (Licence: FL ME118634) | |
| 207W00000X Ophthalmology (Licence: LA 304969) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2023-07-27 |