| NPI | 1801893490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 5783) |
| Additional Taxonomies | 174400000X Specialist (Licence: ND 5783) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2014-06-23 |