| NPI | 1477083194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 72093-20) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2021009866) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-08-15 |