| NPI | 1275698516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 050261) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 50261) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-10-31 |