| NPI | 1659637668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WA 60820884) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA 60820884) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2023-06-29 |