| NPI | 1578653069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E-3688) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: AR E-3688) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-31 |