| NPI | 1548200082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA C41974) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 53565) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-10-23 |