| NPI | 1427187301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 15252) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX E0280) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2015-08-12 |