| NPI | 1205179496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WA MD60939902) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207W00000X Ophthalmology (Licence: WA MD60939902) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2023-07-18 |