| NPI | 1780052233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA C173301) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2019018140) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2019018140) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2022-01-10 |