| NPI | 1528068640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NV 9250) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 9250) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2024-05-14 |