| NPI | 1215497920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA 1215497920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A181849) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A181849) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-07-17 |