| NPI | 1679751358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 4519) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA OS014462) |
| 207W00000X Ophthalmology (Licence: FL OS13484) | |
| 207W00000X Ophthalmology (Licence: MA 278557) | |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2021-09-23 |