| NPI | 1396852943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO 0050343) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 50343) |
| 207W00000X Ophthalmology (Licence: NM MD2012-0618) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2012-0618) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2018-01-18 |