| NPI | 1902828007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA g58694) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G58694) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |