| NPI | 1164913539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: CA A183138) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: CA F537) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2025-01-23 |