| NPI | 1124224936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.122157) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35122157) |
| 207W00000X Ophthalmology (Licence: IN 01069289) | |
| 207W00000X Ophthalmology (Licence: CO 47547) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2021-05-21 |