| NPI | 1285746578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX J6009) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 10613R) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-12-03 |