| NPI | 1508048802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 69159) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A107685) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2023-04-17 |