| NPI | 1366492365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AL 26319) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AL 00026319) |
| 207W00000X Ophthalmology (Licence: FL ME93012) | |
| 207W00000X Ophthalmology (Licence: MS 19476) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-07-09 |