| NPI | 1215926126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN MD0000021088) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD0000021088) |
| 207W00000X Ophthalmology (Licence: KY 28160) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 28160) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2017-08-04 |