| NPI | 1225353626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2015-00607) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD60301767) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2023-09-21 |