| NPI | 1043690233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WI 7549520) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301117444) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2023-08-29 |