| NPI | 1861790826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 67588) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A116847) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2020-12-03 |