| NPI | 1588923429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 49063) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R3096) |
| Enumeration Date | 2012-05-13 |
| Last Update Date | 2022-10-10 |