| NPI | 1518000116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.121737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P20611) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-08-27 |