| NPI | 1487978359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 56785) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD455934) |
| 207W00000X Ophthalmology (Licence: MD D0077731) | |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2020-01-28 |