| NPI | 1427036706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M3742) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 45628) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2007-07-08 |