| NPI | 1518991678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 52921) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A91472) |
| 207W00000X Ophthalmology (Licence: MI 070074) | |
| 207W00000X Ophthalmology (Licence: ND LT 11456) | |
| 207W00000X Ophthalmology (Licence: ND 11456) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-09-01 |