| NPI | 1700346756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301509771) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301509771) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-01-17 |