| NPI | 1639494289 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MB09698300) |
| Additional Taxonomies | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: NJ 25MB09698300) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2020-09-07 |