| NPI | 1548220171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 47705) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 5101014815) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2020-10-07 |