| NPI | 1457305625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NV 10505) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NV 10505) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-08-17 |