| NPI | 1215226014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM MD2017-0187) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A123717) |
| 207W00000X Ophthalmology (Licence: OR MD176549) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2023-07-13 |