| NPI | 1093840944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: LA 303230) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 045129) |
| 207W00000X Ophthalmology (Licence: LA 303230) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-10-06 |