| NPI | 1669573713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MT MED-PHYS-LIC-34434) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: HI MD-10406) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-04-21 |