| NPI | 1417006479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A123024) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD436469) |
| 207W00000X Ophthalmology (Licence: PA MT189078) | |
| 207W00000X Ophthalmology (Licence: WA MD60212570) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2014-03-07 |