| NPI | 1881662708 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.062506) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35062506) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2021-02-22 |