| NPI | 1275616963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA C-34407) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C34407) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-05-09 |