| NPI | 1578688461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G20752) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G20752) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2023-02-22 |