| NPI | 1730490970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 32858) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC MMD.32858 LL) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2020-08-17 |