| NPI | 1689851958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 64491) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0064514) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2012-03-27 |