| NPI | 1891730073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A65262) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 18266) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2024-05-20 |