| NPI | 1043248032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301078018) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 2005008376) |
| 207W00000X Ophthalmology (Licence: MI 4301078018) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-06-23 |