| NPI | 1043530777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A130661) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 130661) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2020-10-28 |