| NPI | 1285990671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A148366) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 49187) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2018-10-03 |