| NPI | 1518748284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD483694) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA LT000976) |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-09-13 |