| NPI | 1265609275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 249083) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A98056) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2013-12-18 |