| NPI | 1982874509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 010852) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 1576) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2024-06-26 |