| NPI | 1447387279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 20A17687) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 46954) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-06-17 |