| NPI | 1932378502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WV 10571) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101030238) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |