| NPI | 1326205048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO 53516) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 231866) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2018-05-10 |