| NPI | 1376505172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NH 19096) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 47283) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2018-07-25 |