| NPI | 1356469050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301086264) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A108611) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2021-12-01 |