| NPI | 1396729620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2004-01631) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 23887) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2022-07-21 |