| NPI | 1922488246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301504944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107381) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A160968) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2022-01-26 |