| NPI | 1013951409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OK 28311) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 28311) |
| 207W00000X Ophthalmology (Licence: MI 4301093697) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-04-12 |