| NPI | 1801094990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 93992) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD440801) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2023-01-11 |