| NPI | 1477814739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0108X Ophthalmology Uveitis and Ocular Inflammatory Disease (Licence: AZ 53975) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 53975) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: AZ 53975) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2019-05-07 |