| NPI | 1538123161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 00982) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 9800982) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-11-17 |