| NPI | 1831360031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD037324) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301081294) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2023-10-05 |