| NPI | 1043417751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA MD.203115) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A93573) |
| 207W00000X Ophthalmology (Licence: NC 2008-00586) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2009-07-14 |