| NPI | 1316141914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO 46910) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP1-0018217) |
| 207W00000X Ophthalmology (Licence: FL me99294) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2008-09-03 |