| NPI | 1457373466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 21196) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR E2275) |
| 207W00000X Ophthalmology (Licence: MO 107786) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-04-10 |