| NPI | 1982601613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM 95-62) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM 9562) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2023-07-15 |