| NPI | 1073659769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 2011-00308) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2011-00308) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-09-24 |