| NPI | 1548270143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 4230) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 044736) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2009-11-23 |