| NPI | 1346655099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 007053) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A13378) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2018-05-15 |