| NPI | 1346241965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME84764) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME84764) |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2018-05-10 |