| NPI | 1356329809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD24958) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD24958) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2024-02-09 |