| NPI | 1427016534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 046302) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 046302) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 046302) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: SC md23446) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2017-05-08 |