| NPI | 1487215380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A202381) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO A202381) |
| Enumeration Date | 2019-06-23 |
| Last Update Date | 2025-08-25 |