| NPI | 1477042711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 89877) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.144347) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2023-07-08 |