| NPI | 1508826918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 29034-20) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 35147) |
| 207W00000X Ophthalmology (Licence: IL 036120295) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2021-12-30 |