| NPI | 1871545434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A85961) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301089354) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2014-01-03 |