| NPI | 1073845921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 4545) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX N5933) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2016-12-13 |