| NPI | 1912104993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ AU29035990415) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A94666) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2021-12-15 |