| NPI | 1992902381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D0074393) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A116617) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2014-07-02 |