| NPI | 1427048693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD23935) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD23935) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A64569) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-12-03 |