NPI | 1992090625 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA SFP53) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301093385) |
Enumeration Date | 2011-06-10 |
Last Update Date | 2025-09-02 |