| NPI | 1831307594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NM MD2009-0470) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA R-7727) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-07-20 |