| NPI | 1629047956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 24403) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 8928) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-11-29 |