| NPI | 1245751106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 88662) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 2551206) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-07-06 |