| NPI | 1033225586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX 43812) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 28979) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2013-11-07 |