| NPI | 1538277330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 011657) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA 11657) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2018-10-17 |