| NPI | 1346535481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID O-0860) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 1346535481) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-05-08 |