| NPI | 1588684518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 06341R) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R3119) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-10-23 |