| NPI | 1588824221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2014004822) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 26575) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2018-01-31 |