| NPI | 1295731040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 8411) |
| Additional Taxonomies | 174400000X Specialist (Licence: ND 8411) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2014-06-23 |