| NPI | 1326268475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD431770) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: DE C1-0009162) |
| 207W00000X Ophthalmology (Licence: NJ 25MA08900500) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD431770) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NJ 25MA08900500) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: DE CI-0009162) | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2019-05-06 |