| NPI | 1396986329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2016-01889) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD436536) |
| 207W00000X Ophthalmology (Licence: MA 242678) | |
| 207W00000X Ophthalmology (Licence: MI 4301104085) | |
| Enumeration Date | 2009-03-22 |
| Last Update Date | 2016-08-31 |