| NPI | 1003884297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GU M-1658) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MT 10976) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2017-03-21 |