| NPI | 1740338607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G86105) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA G86105) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-08-23 |