| NPI | 1538293279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 200900527) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC LL 27940) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2009-10-14 |