| NPI | 1669853768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301507112) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A168016) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-01-10 |