| NPI | 1710071170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 12366) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G35524) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-11-21 |