| NPI | 1306812979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA C53104) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 200300335) |
| 207W00000X Ophthalmology (Licence: CA c53104) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2017-03-31 |