| NPI | 1225241763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2007-00708) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101241350) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-02-08 |