| NPI | 1326098286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101248581) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 40953) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-06-10 |