| NPI | 1598092165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 52867) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT189349) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2020-03-17 |