| NPI | 1184866584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A130614) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 250488) |
| 207W00000X Ophthalmology (Licence: CA A130614) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2021-04-29 |