| NPI | 1417284647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN DO0000002191) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI L1624782) |
| 207W00000X Ophthalmology (Licence: TN 2191) | |
| 207W00000X Ophthalmology (Licence: OK 5879) | |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2024-05-15 |