| NPI | 1073624706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: PA MD020304E) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD020304E) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-04-11 |