| NPI | 1487866588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A106255) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 49176) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2022-01-06 |