| NPI | 1316199326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A114976) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT191244) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2012-10-19 |