| NPI | 1588678924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301080122) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A96155) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2024-08-20 |