| NPI | 1265431126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 53432-020) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-07-0691G) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2016-11-22 |