| NPI | 1225086655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI MD14426) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R7N60) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2013-10-22 |