| NPI | 1215932033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: OR MD25478) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA MD00044319) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: WA MD00044319) | |
| 207W00000X Ophthalmology (Licence: OR MD25478) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2024-10-01 |