| NPI | 1073770707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD166472) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA 60443698) |
| 207W00000X Ophthalmology (Licence: OR 166472) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WA MD60443698) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2021-04-02 |