| NPI | 1568637361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A100887) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A100887) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2013-02-14 |