| NPI | 1831118363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: OH 35067301) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35-06-7301-E) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-06-01 |