| NPI | 1780849331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 60611) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A112358) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2013-09-16 |