| NPI | 1457345704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR C4565) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR C4565) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2012-04-30 |