| NPI | 1790149896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A168327) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D94131) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2023-09-06 |