| NPI | 1114260668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A149383) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD61289525) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2022-07-06 |