| NPI | 1437386737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD61561497) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 56524) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2025-03-18 |