| NPI | 1124346648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 32575) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC MMD.32575 LL) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2020-10-15 |