| NPI | 1023065612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2005-01135) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 2005-01135) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-11-05 |