| NPI | 1922012103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 200400072) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2004-00072) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-04-06 |