| NPI | 1255494001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 66457) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C54100) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-09-15 |