| NPI | 1881937720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A133231) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-44228) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2023-11-09 |