| NPI | 1801873401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 0057503) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MT 12275) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-08-07 |