| NPI | 1194024935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282N00000X General Acute Care Hospital (Licence: CA Co32402) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C032402) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2011-03-18 |