| NPI | 1184708703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID M4909) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA GFE9724) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |