| NPI | 1790862522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: AZ 11672) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 11672) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2021-05-12 |