| NPI | 1861131765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MTL500001834op) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MTL500001834) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |