| NPI | 1477997591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD212048) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 51523) |
| 207W00000X Ophthalmology (Licence: KY R3264) | |
| 207W00000X Ophthalmology (Licence: OH 35.133827) | |
| 207W00000X Ophthalmology (Licence: TX R2663) | |
| 207W00000X Ophthalmology (Licence: KY TP588) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2024-06-07 |