| NPI | 1558998328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD484318) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0029114) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-03-04 |