| NPI | 1003029026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.128736) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD29310) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-06-24 |