| NPI | 1932556875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A156503) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A156503) |
| 207W00000X Ophthalmology (Licence: MA 283061) | |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2024-11-07 |