| NPI | 1144292202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME75330) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL 75330) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2019-01-16 |