| NPI | 1598846321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD431192) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 57-008295) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-05-07 |