| NPI | 1649297508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 17174) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 17938) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2013-04-11 |