| NPI | 1427090976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARHAD KAYVAN SHOKOOHI Owner 989-793-2820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301102705) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 43010040619) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2018-01-19 |