| NPI | 1164464103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D40106) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D40106) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-04-10 |