| NPI | 1467951814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2023-01172) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 18657) |
| 207W00000X Ophthalmology (Licence: FL OS18657) | |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2025-08-20 |