| NPI | 1164481230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD21723) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 20157) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2021-09-17 |