| NPI | 1609459239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX 48304) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR E-15520) |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2024-10-17 |