| NPI | 1912138140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MD D75487) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A115095) |
| 207W00000X Ophthalmology (Licence: MI 4301106609) | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2024-02-24 |