| NPI | 1215027115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.122579) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35122579) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD450342) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-05-24 |