| NPI | 1639161995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 19913) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 19913) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2010-10-13 |