| NPI | 1982018594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 33601) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2014018140) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2018-08-01 |