| NPI | 1164728044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX P3302) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 5101017963) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2023-05-10 |