| NPI | 1861636581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 85288) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0053651) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2025-10-07 |