| NPI | 1881653749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 011264) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 15827) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2012-10-23 |