| NPI | 1699301606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A191643) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 1022742) |
| 207W00000X Ophthalmology (Licence: CA A191643) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2026-09-02 |