| NPI | 1225082258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL 0022532) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME22532) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-03-17 |