| NPI | 1629177241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A50917) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A50917) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-06-06 |