| NPI | 1194345975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA 195274) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A195274) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-08-20 |