| NPI | 1851350995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL MD26750) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 058065) |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2012-04-11 |