| NPI | 1376723759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A87650) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A87650) |
| 207W00000X Ophthalmology (Licence: TX M8258) | |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2017-04-05 |