| NPI | 1336167618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G81085) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA a65973) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-04-01 |