| NPI | 1881666006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME136050) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 90743) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2024-07-03 |