| NPI | 1962020644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U8999) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2020014715) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2024-07-17 |