| NPI | 1710966320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 46209-020) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 66047) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2023-07-21 |