| NPI | 1396137865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A185699) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 54051) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2023-08-23 |