| NPI | 1235115296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 00008298) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000017459) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2008-11-18 |