| NPI | 1861459380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AL 26502) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 47442) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2011-08-01 |