| NPI | 1437394947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.099391) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.099391) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2021-04-30 |