| NPI | 1598101933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 69579) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2017-00840) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2018-09-06 |