| NPI | 1295708402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 9336) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA L05984R) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-25 |