| NPI | 1689611345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35.087894) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 40444) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-12-18 |