| NPI | 1366855694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 23181) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101259039) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2023-11-02 |