| NPI | 1144422908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P1953) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A130749) |
| 207W00000X Ophthalmology (Licence: MO 2011006231) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2020-07-07 |