| NPI | 1114901758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR 14736) |
| Additional Taxonomies | 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: OR 14736) |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: WA 37155) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2017-04-24 |