| NPI | 1346610862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A158653) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 286985) |
| Enumeration Date | 2015-09-26 |
| Last Update Date | 2023-09-20 |