| NPI | 1821088147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD00014109) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: ID M3387) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2008-04-30 |