| NPI | 1194777185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME136187) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.130104) |
| 207W00000X Ophthalmology (Licence: IN 01059189A) | |
| 207W00000X Ophthalmology (Licence: KY 37798) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-02-04 |