| NPI | 1194721134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: MO 2016004988) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO R5138) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2021-05-10 |