| NPI | 1942644083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID M-14591) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 304250) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2022-09-19 |