| NPI | 1285891986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 053675) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2012-00628) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2020-07-07 |