| NPI | 1669685889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 200801173) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 2008-01173) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2013-04-11 |