| NPI | 1508070566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A119711) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A119711) |
| 207W00000X Ophthalmology (Licence: OR LL18311) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR 16560) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2022-06-06 |