| NPI | 1326135716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA OS014317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT011570) |
| 207W00000X Ophthalmology (Licence: OH 34.010643) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2018-07-26 |