| NPI | 1669534483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD152539) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G81104) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2011-08-18 |