| NPI | 1396788725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD00049354) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000041069) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2017-11-22 |