| NPI | 1093058059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101266753) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DC MD047178) |
| 207W00000X Ophthalmology (Licence: VA 0101266753) | |
| 207W00000X Ophthalmology (Licence: CA A149244) | |
| 207W00000X Ophthalmology (Licence: MD D0087912) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD047178) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0087912) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2019-11-12 |