| NPI | 1417077983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A103681) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MT184548) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-06-05 |