| NPI | 1659391837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2007-01744) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD424737) |
| 207W00000X Ophthalmology (Licence: WA MD60773227) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-08-28 |