| NPI | 1285098533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 86281) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP10059014) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2022-10-10 |