| NPI | 1831393644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL OS15829) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 20A 10704) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-03-10 |