| NPI | 1306281852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 25557) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD.33497) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2018-07-06 |