| NPI | 1851826630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2023-01503) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX T0330) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2023-07-31 |