| NPI | 1295779684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 37351) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2006007890) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-09-24 |