| NPI | 1952380834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA C146976) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 48053) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2017-03-24 |