| NPI | 1891726766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC MD29305) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 9901413) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-07-29 |