| NPI | 1376584433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA C40316) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA C40316) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2014-08-07 |