| NPI | 1730208737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 70942) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD433118) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2026-08-20 |