| NPI | 1457513236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N7058) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME112064) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-09-29 |