| NPI | 1033206586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: DC MD14016) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0029586) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-11-05 |