| NPI | 1093943086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: UT 10574949-1205) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: OR MD171333) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2022-12-09 |