| NPI | 1730191081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 44363) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 23344) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2011-10-05 |