| NPI | 1578983383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D87228) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301105702) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2023-05-19 |