| NPI | 1578570529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G27304) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM 95-161) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2008-01-28 |