| NPI | 1932236700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 32988) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 18044) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-01-16 |