| NPI | 1740575091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD214848) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2015013108) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2024-08-03 |