| NPI | 1245344605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 103873) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME85158) |
| 207W00000X Ophthalmology (Licence: IL 036.094392) | |
| 207W00000X Ophthalmology (Licence: OH 35.082957) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: MO 103873) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-01-26 |