| NPI | 1285634105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: PA MD018980E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD018980E) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2022-07-21 |