| NPI | 1205947496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 25970) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: GA 025970) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-11-24 |