| NPI | 1992804504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA C50523) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA C50523) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-03-04 |