| NPI | 1467029348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.153466) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA R-12087) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2025-06-23 |