| NPI | 1932171147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME138918) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 033805) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2023-04-12 |