| NPI | 1144724899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 29900) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD44074) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2022-12-22 |