| NPI | 1851323273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A053507) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD20763) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-12-15 |