| NPI | 1003166000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA OS017847) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD H0083315) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2019-08-13 |