| NPI | 1376542555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 3484) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C033718) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2008-07-15 |