| NPI | 1740281641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME56586) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME0056327) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2011-05-11 |