| NPI | 1275890246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A151162) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.130561) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2018-07-26 |