| NPI | 1013959279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA 13092) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G8840) |
| 207W00000X Ophthalmology (Licence: OR MD08581) | |
| 207W00000X Ophthalmology (Licence: AZ 7514) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA02104100) | |
| 207W00000X Ophthalmology (Licence: MO R4176) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |