| NPI | 1255598041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD157057) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD157057) |
| 207W00000X Ophthalmology (Licence: WA MD60493369) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WA MD60493369) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2017-10-23 |