| NPI | 1467568485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM MD2011-0677) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2009005095) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2011-11-28 |