| NPI | 1366530792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G47836) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL MD.31581) |
| 207W00000X Ophthalmology (Licence: NM MD2006-0818) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-12-23 |