| NPI | 1144249277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M4373) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 56146) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2022-09-02 |