| NPI | 1528154465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 034529) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 034529) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-05-26 |