| NPI | 1609097369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.093493) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 061086) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2025-07-23 |