| NPI | 1114254711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: ID M-15046) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C148445) |
| 207W00000X Ophthalmology (Licence: SD 7997) | |
| 207W00000X Ophthalmology (Licence: OR MD151338) | |
| 207W00000X Ophthalmology (Licence: WA MD 60151762) | |
| 207W00000X Ophthalmology (Licence: PA MD438137) | |
| 207W00000X Ophthalmology (Licence: ID M-15046) | |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2021-11-04 |