| NPI | 1265444541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 44773) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM 80-221) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2026-01-21 |