| NPI | 1083935068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 59282) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 41882) |
| 207W00000X Ophthalmology (Licence: IL 036137863) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2017-01-31 |