| NPI | 1275699274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX N2888) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: TX N2888) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2017-05-04 |