| NPI | 1639526072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A168267) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03643) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-09-04 |