| NPI | 1417481946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.141623) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35141623) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD479866) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-04-05 |