| NPI | 1821359415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: PA OS018142) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA OS018142) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2017-10-20 |