| NPI | 1225443997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A174746) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 65296) |
| Enumeration Date | 2014-06-21 |
| Last Update Date | 2022-08-10 |