| NPI | 1700239530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CT 70565) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA a168607) |
| Enumeration Date | 2016-07-17 |
| Last Update Date | 2022-09-01 |