| NPI | 1881665453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX L0604) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX L0604) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2007-07-08 |