| NPI | 1033189501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: SC 28369) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 51916) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-09-06 |