| NPI | 1306097183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA F 5491) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2005-00491) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |