| NPI | 1043277361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G73198) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G73198) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2026-03-03 |