| NPI | 1245233584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA GA 049646) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 7780) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2022-12-23 |