| NPI | 1184809956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD478590) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MT 11639) |
| Enumeration Date | 2007-12-29 |
| Last Update Date | 2023-02-08 |