| NPI | 1942294038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A89874) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM 2005-0295) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2020-01-10 |