| NPI | 1518068329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL 047073) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 024091) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-07-08 |