| NPI | 1033505086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 87920) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2019014155) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2019014155) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-10-15 |