| NPI | 1427054808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: KY 53305) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD073712L) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2019-12-13 |