| NPI | 1447756622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 75931) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.144544) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-11-14 |