| NPI | 1457322877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 00018908) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000024535) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2018-01-11 |