| NPI | 1942345228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ID M11139) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A98662) |
| 207W00000X Ophthalmology (Licence: UT 5755878-1205) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2012-10-30 |