| NPI | 1649316753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA a37277) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA a37277) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-10-24 |