| NPI | 1538125414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: RI MD5359) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 038372) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2017-05-04 |