| NPI | 1295727584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 75427) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VT 042.0018151) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2024-12-11 |