| NPI | 1164525598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A95523) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 5852453) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2013-05-09 |