| NPI | 1245246263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 22901) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 35727) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2009-03-20 |