| NPI | 1285664375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA 60051007) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A96009) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2024-11-08 |