| NPI | 1396798666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 28823) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 12652) |
| 207W00000X Ophthalmology (Licence: NC 28823) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2023-06-06 |