| NPI | 1972528222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD431784) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 200501859) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2015-04-07 |