| NPI | 1255322665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 55109) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 055109) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2022-08-22 |