| NPI | 1154765139 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207WX0120X Ophthalmology, Cornea and External Diseases Specialist (Licence: CA A154913)  | 
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A154913)  | 
| Enumeration Date | 2013-04-22 | 
| Last Update Date | 2021-09-20 |