| NPI | 1881688216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 111966) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 2776) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2015-08-05 |