| NPI | 1942494703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N5734) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME 99889) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2020-10-28 |