| NPI | 1205064441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 071479) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A125413) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-01-10 |