| NPI | 1467547364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OH 35057803) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G166065) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-09-24 |