| NPI | 1912968371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 49461) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 039169) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2017-07-27 |