| NPI | 1306044102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A115710) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A115710) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2016-08-10 |