| NPI | 1992844864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 058533) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA MD026175) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2008-12-05 |