| NPI | 1316999642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: OR MD13338) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD13338) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2017-10-23 |