| NPI | 1700047453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 072026) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC 204188) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-11-22 |