| NPI | 1275561581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 4390) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ND 6525) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2013-05-20 |