| NPI | 1326128455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA G63254) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA 000000G63254) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-02-21 |