| NPI | 1386702819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A78163) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 101277785) |
| 207W00000X Ophthalmology (Licence: CA A78163) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2024-04-04 |