| NPI | 1588242606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A203161) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO DR.0078144) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2026-08-13 |