| NPI | 1851702195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VT 042.0014963-COVID) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 274689) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2020-09-04 |