| NPI | 1346685633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD192975) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A146507) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2022-07-21 |