| NPI | 1922127406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0102037038) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0102037038) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-02-01 |