| NPI | 1871895110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 68195-21) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: RI DO00748) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2017-11-01 |