| NPI | 1730348921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A131080) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2012-00356) |
| 207W00000X Ophthalmology (Licence: CA A131080) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2017-04-05 |