| NPI | 1154534477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2009-00712) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 060667) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-04-29 |