| NPI | 1801818901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301082763) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA g27232) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-03-21 |