| NPI | 1598260655 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A194866)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD d93753)  | 
| Enumeration Date | 2018-03-29 | 
| Last Update Date | 2024-07-02 |