| NPI | 1154526192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A113627) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 75371) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0058675) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2023-03-21 |