| NPI | 1952388308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2016-00709) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IL 036-082190) |
| 207W00000X Ophthalmology (Licence: IA 27985) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2016-06-28 |