| NPI | 1336196815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: KY 36686) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 36686) |
| 207WX0108X Ophthalmology Uveitis and Ocular Inflammatory Disease (Licence: KY 36686) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2023-03-07 |