| NPI | 1477088979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A191729) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A191729) |
| 207W00000X Ophthalmology (Licence: FL ME150161) | |
| Enumeration Date | 2017-04-22 |
| Last Update Date | 2025-06-05 |