| NPI | 1598918666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 7154752-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NV 14377) |
| Enumeration Date | 2008-11-02 |
| Last Update Date | 2017-07-05 |