| NPI | 1942286018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 36496) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 16420) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2023-10-05 |