| NPI | 1649488594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 33461) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 26156) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-07-22 |