| NPI | 1316993124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD032125E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD032125E) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2010-11-23 |