| NPI | 1487872412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MA 242742) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 242742) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-12-20 |