| NPI | 1144255324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN MD42489) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000042489) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-04-04 |