| NPI | 1285830323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI MD14427) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2009-00806) |
| 207W00000X Ophthalmology (Licence: OH 57.009639) | |
| 207W00000X Ophthalmology (Licence: WA MD60157794) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2021-05-20 |