| NPI | 1922466671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL OS17305) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 6869) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2022-12-08 |