| NPI | 1467650135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.140495) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX BP1-0037529) |
| 207R00000X Internal Medicine (Licence: MA 239928) | |
| 207W00000X Ophthalmology (Licence: PA MD454412) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WV WV25265) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2024-04-04 |