| NPI | 1891870697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA wa0004791) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: HI md10934) |
| 207W00000X Ophthalmology (Licence: OR MD18566) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2024-05-09 |