| NPI | 1174729016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AR E9102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5622) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2019-04-08 |