| NPI | 1881691335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TN 19486) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME58780) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A39159) | |
| 208000000X Pediatrics (Licence: CA A39159) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2023-12-27 |