| NPI | 1043415607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 250088) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-232314) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2013-10-23 |