| NPI | 1699965509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VT 042.0013083) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD27674) |
| 207W00000X Ophthalmology (Licence: VT 042.0013083) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2015-02-17 |