| NPI | 1487074191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0065378) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 56343) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2024-04-19 |