| NPI | 1164512026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME MD15441) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ND 8944) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2013-04-02 |