| NPI | 1255759981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A170817) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 55602) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2022-11-21 |