| NPI | 1962631788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 22666) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS au5009697-1595) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2015-06-18 |