| NPI | 1427546779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 70907) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 11410818-1205) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-06-07 |