| NPI | 1114950060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: CA G37539) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G37539) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-08-04 |