| NPI | 1174973416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 5101025415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101022292) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2020-07-20 |