| NPI | 1245440437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 25597) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 38941) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-09-10 |