| NPI | 1730273590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME96010) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 27669) |
| 207W00000X Ophthalmology (Licence: CA A95542) | |
| 207W00000X Ophthalmology (Licence: TN MD39860) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2013-11-27 |