| NPI | 1427059351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: SC 14505) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 14505) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2017-08-04 |