| NPI | 1457321903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA a98352) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME124912) |
| 207W00000X Ophthalmology (Licence: MO 2004016660) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2020-07-31 |