| NPI | 1295885960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD152518) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT188088) |
| 207W00000X Ophthalmology (Licence: CA A102221) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2013-02-01 |