| NPI | 1154367902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301052641) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301052641) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-01-26 |