| NPI | 1427097773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD422051) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35087206) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2018-11-29 |