| NPI | 1043289150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI SB053937) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI SB053937) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-11-24 |