| NPI | 1447257266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD00031796) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00031796) |
| 207W00000X Ophthalmology (Licence: WA 00031796) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-09-18 |