| NPI | 1972534253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G845350) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G845350) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-06-16 |