| NPI | 1932596988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WA 61043684) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA 61043684) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2020-06-18 |