| NPI | 1922072966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A78100) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A78100) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-05-12 |