| NPI | 1437302049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX P1583) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 63800) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX P1583) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2017-04-19 |