| NPI | 1457670606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2016-00660) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301 096 311) |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2018-05-07 |