| NPI | 1851342166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 70247) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 8717) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-09-25 |