| NPI | 1861484032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 92300) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD426282) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-09-12 |