| NPI | 1316952005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G34472) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G34472) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2013-04-30 |