| NPI | 1356514053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 76154-20) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 24758) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2021-12-30 |