| NPI | 1972563781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD16253) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G58765) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2021-02-11 |