| NPI | 1295152379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A139016) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0060710) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2020-07-08 |