| NPI | 1598414641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 74599) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 32438) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2023-07-11 |