| NPI | 1174937163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD191916) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-44979) |
| 207W00000X Ophthalmology (Licence: RI LP03284) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IA MD-44979) | |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: IA MD-44979) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2023-05-24 |