| NPI | 1487099412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX T4484) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A134004) |
| 207W00000X Ophthalmology (Licence: TX 573271) | |
| 207W00000X Ophthalmology (Licence: MI 4301111563) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301111563) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX T4484) | |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2022-12-16 |