| NPI | 1407859556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 11743) |
| Additional Taxonomies | 174400000X Specialist (Licence: NH 11743) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2020-04-23 |