| NPI | 1477759454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME154995) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: HI MD-17140) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-02-24 |