| NPI | 1053519447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A108283) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT190663) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2011-07-15 |