| NPI | 1376501635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX H9162) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX H9162) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA G69442) | |
| 207W00000X Ophthalmology (Licence: CA G69442) | |
| 207W00000X Ophthalmology (Licence: MA 73015) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MA 73015) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-07-23 |