| NPI | 1124097589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: OK 21825) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OK 21825) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2017-12-28 |