| NPI | 1376701391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL MD.30827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116019362) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2011-04-13 |