| NPI | 1801258017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 16424) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R4093) |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2023-12-26 |