| NPI | 1003878075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA MD.013332) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 013332) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2014-05-23 |