| NPI | 1164506754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 21536) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 21536) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2013-11-18 |