| NPI | 1962474247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: CA G84475) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 28334) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: AZ 28334) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2024-08-12 |