| NPI | 1184687089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL AS9252040) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME30852) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2019-05-21 |