| NPI | 1306227335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX R9465) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX R9465) |
| 207W00000X Ophthalmology (Licence: MI 4301105348) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-11-22 |