| NPI | 1659909620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A208658) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD484118) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-09-09 |