| NPI | 1225044324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301053513) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 11017) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-07-21 |