| NPI | 1205907102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G72159) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO DR.0057516) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2023-10-18 |