| NPI | 1780786491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M4343) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2007-00618) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2011-09-26 |