| NPI | 1326272295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: UT 9235989-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 9235989-1205) |
| 207W00000X Ophthalmology (Licence: WI 54927) | |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2018-02-05 |