| NPI | 1679791982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M6380) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M6380) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-06-13 |