| NPI | 1912991845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 5101014377) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 5101014377) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2024-08-20 |