| NPI | 1144485053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD159467) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD60336532) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2021-02-20 |