| NPI | 1649710062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX U5423) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A172237) |
| Enumeration Date | 2017-03-04 |
| Last Update Date | 2023-08-21 |