| NPI | 1306839212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35029197A) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C29920) |
| 207W00000X Ophthalmology (Licence: MO R3888) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2008-01-29 |