| NPI | 1487698288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: OH 35067637) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35067637) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-04-30 |