| NPI | 1700015716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME120847) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R71638) |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2017-06-26 |