| NPI | 1396719332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101046862) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101046862) |
| 207W00000X Ophthalmology (Licence: DC MD19548) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0045307) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2017-07-07 |