| NPI | 1629088109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA G48096) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G48096) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-06-24 |