| NPI | 1447544192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA 44232) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 63597) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: IA 44232) | |
| Enumeration Date | 2011-05-30 |
| Last Update Date | 2018-03-17 |