| NPI | 1255471181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 29002) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 29002) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2015-06-18 |