| NPI | 1710178439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD439018) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT189009) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2019-06-05 |