| NPI | 1316999725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA 23573) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 27923) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2010-09-08 |