| NPI | 1093956013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA C184030) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 0000000) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2023-03-10 |