| NPI | 1245572916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 04-41934) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2019008671) |
| 207W00000X Ophthalmology (Licence: MO 2019008671) | |
| 207W00000X Ophthalmology (Licence: IA MD-44129) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 04-41934) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IA MD-44129) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2022-09-01 |