| NPI | 1710033394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX m6912) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0059406) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2018-12-19 |