| NPI | 1023298643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: FL ME103859) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A96195) |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2013-05-28 |