| NPI | 1750397576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD178830) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 6771485-1205) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-06-07 |