| NPI | 1871724781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VT 042-0013420) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C141804) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2018-08-13 |