| NPI | 1093722878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 35917) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR E1703) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-02-22 |