| NPI | 1356636492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC MMD 33822) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC MMD.33822 LL) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2016-08-03 |