| NPI | 1013974427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME106417) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 047023) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2018-05-15 |