| NPI | 1053387365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A83495) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A83495) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2017-01-26 |