| NPI | 1801986625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 12891) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A95100) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-11-21 |