| NPI | 1508062399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2011-00075) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC RTL140925) |
| 207W00000X Ophthalmology (Licence: NC 140925) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2011-09-13 |