| NPI | 1508397050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD MD26618) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 75332-20) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-08-02 |