| NPI | 1245255579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2022-01019) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 025684) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2022-06-08 |