| NPI | 1942279138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 26082) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 14216) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2012-12-31 |