| NPI | 1073510962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-31680) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MS 16323) |
| 207W00000X Ophthalmology (Licence: MO 2005041174) | |
| 207W00000X Ophthalmology (Licence: TX M9839) | |
| 207W00000X Ophthalmology (Licence: LA MD.08085R) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MS 16323) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2005041174) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 0431680) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: LA MD.08085R) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX M9839) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-09-01 |