| NPI | 1477744068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 076153) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101247198) |
| 207W00000X Ophthalmology (Licence: MD D70402) | |
| 207W00000X Ophthalmology (Licence: MO 2006017512) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2022-01-10 |