| NPI | 1427347228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2015-00363) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WV 26038) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2015-08-23 |