| NPI | 1093182669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 209800000X Legal Medicine (Licence: VA 0101037698) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101037698) |
| Enumeration Date | 2015-08-30 |
| Last Update Date | 2015-08-30 |