| NPI | 1346431087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD436524) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT186766) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2009-06-24 |