| NPI | 1134398167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL 4967) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL OS-0004967) |
| Enumeration Date | 2008-02-24 |
| Last Update Date | 2016-07-27 |