| NPI | 1962541847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A112736) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 231238) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2021-02-24 |