| NPI | 1295727634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 100986) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0110840384) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2011-02-04 |