| NPI | 1861448177 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD13435) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD13455) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2014-08-15 |