| NPI | 1932416781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 20A12253) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA OT012630) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2012-07-31 |