| NPI | 1093711186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 049112) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME71025) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2017-06-13 |