| NPI | 1962766451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A137389) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A137389) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2020-10-15 |