| NPI | 1154615383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A126196) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.126726) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2025-02-06 |