| NPI | 1720085889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM NM145) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM 71-145) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2008-11-05 |