| NPI | 1487680070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 72754) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC md035308) |
| 207W00000X Ophthalmology (Licence: VA 0101237554) | |
| 207W00000X Ophthalmology (Licence: MD D0062600) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-12-21 |