| NPI | 1437475902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: KS 0439085) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX Q0935) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2018-01-29 |