| NPI | 1992885073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301090440) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2005-01077) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2019-11-25 |