| NPI | 1629129044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M1213) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A91814) |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2016-04-25 |