| NPI | 1225089709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 30163) |
| Additional Taxonomies | 207ZP0101X Pathology, Anatomic Pathology (Licence: WI 30163) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2015-01-20 |