| NPI | 1891736633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0032593) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA OP00002094) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2017-02-02 |