| NPI | 1225035827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX L7021) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A90506) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2014-10-13 |