| NPI | 1508837279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G58380) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G58380) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-11-02 |