| NPI | 1285888628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: CA A120584) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A120584) |
| 207W00000X Ophthalmology (Licence: MI 4301090874) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2017-04-05 |