| NPI | 1720047210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 220670) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 220670) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2007-10-24 |