| NPI | 1891180428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 278738) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 22949) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2022-10-18 |