| NPI | 1861447203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SD 1230) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 16310) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-06-09 |