| NPI | 1770546574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 9198) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 9198) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2013-12-19 |