| NPI | 1528336989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KY 50982) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 01131) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2018-09-06 |