| NPI | 1992870620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: LA 012301) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C52485) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2008-12-11 |