| NPI | 1114032687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD26783) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD60005640) |
| 207W00000X Ophthalmology (Licence: OR MD26783) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WA MD60005640) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-07-26 |