| NPI | 1427015973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 14953) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 15070020) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2007-07-08 |