| NPI | 1144259656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX 44326) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 22433) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2013-11-18 |