| NPI | 1043213424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 27278) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 16280) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2008-04-17 |