| NPI | 1225492333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA 61244190) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: WA 61244190) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2023-03-01 |