| NPI | 1285646398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A110458) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 6259385-1205) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-05-27 |