| NPI | 1033122627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD14713) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 23437) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-11-02 |