| NPI | 1013924513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD25921) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD25921) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2013-04-11 |