| NPI | 1982702338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2012-01022) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NH 13221) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-06-12 |