| NPI | 1922462845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 20A19100) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC DO034915) |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist (Licence: CA 20A19100) | |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2022-06-13 |