| NPI | 1700814225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO R7J50) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO R7J50) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-11-16 |