| NPI | 1154550895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 17203) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241262) |
| 207W00000X Ophthalmology (Licence: UT 8583641-1205) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2015-09-11 |