| NPI | 1417094566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 13300) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 13300) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-01-25 |