| NPI | 1003072786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A108797) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 242108) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A108797) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2021-04-05 |