| NPI | 1124298575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA a94767) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A94767) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2023-12-06 |