| NPI | 1801021100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A121273) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH pending) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2023-10-05 |