| NPI | 1952340408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 032337) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC MD 17647) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-07-21 |