| NPI | 1699785238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301053576) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: MI 4301053576) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2019-06-03 |