| NPI | 1467891952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: RI MD16755) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 305063) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2019-09-10 |