| NPI | 1568478402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G83967) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G83967) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2013-04-30 |