| NPI | 1578922092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A151210) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D89497) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2022-05-16 |