| NPI | 1295837466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX M3877) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX M3877) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2008-0449) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2020-06-17 |