| NPI | 1285685032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD27331) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 47815) |
| 207W00000X Ophthalmology (Licence: OR MD27331) | |
| 207W00000X Ophthalmology (Licence: WA MD00042766) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-05-21 |