| NPI | 1265654875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0075032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD 21124) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD442919) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2021-12-06 |