| NPI | 1992723563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 4579) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 48153) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-09-21 |