| NPI | 1093722258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: OR MD175178) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD61066035) |
| 207W00000X Ophthalmology (Licence: OR MD175178) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: WA MD61066035) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-07-26 |