| NPI | 1235343187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA MD201500) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 21052) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2011-09-27 |