| NPI | 1841439254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME112199) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL TRN12692) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2013-09-06 |