| NPI | 1083672539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 14801) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 041172) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2015-08-12 |