| NPI | 1508815259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CT 029918) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 029918) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-10-18 |