| NPI | 1750554507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD436983) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2008-00428) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2023-12-11 |