| NPI | 1083724371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 14891) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101041748) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |