| NPI | 1497971535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 42550) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT189234) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-01-29 |