| NPI | 1568575140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M3618) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX m3618) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2021-03-19 |