| NPI | 1033533195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 20A14201) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0102206481) |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2024-08-03 |