| NPI | 1174572598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 26271) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 13244) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2021-03-31 |