| NPI | 1841639564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2017-02607) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 1489) |
| Enumeration Date | 2013-06-15 |
| Last Update Date | 2018-04-02 |