| NPI | 1801857651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MT 4288) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MT 7288) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2021-04-29 |