| NPI | 1669566535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA C193067) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX S6335) |
| 207R00000X Internal Medicine (Licence: WA MD00044090) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-05-22 |