| NPI | 1093968026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 45025) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY R1832) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2012-04-06 |