| NPI | 1437169661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VT 0420009488) |
| Additional Taxonomies | 207WX0107X Ophthalmology Retina Specialist (Licence: VT 042.0009488) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2022-10-27 |