| NPI | 1801942404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 53068) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 39657) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-06-03 |