| NPI | 1417950833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 1020356) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 14349) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2024-11-06 |