| NPI | 1144949306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA sfp46) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA SFP46) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2023-01-25 |