| NPI | 1952358426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 7032) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G74385) |
| 207W00000X Ophthalmology (Licence: AZ 21433) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-12-17 |