| NPI | 1497750574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 64990) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301061141) |
| 207W00000X Ophthalmology (Licence: OH 64990) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301061141) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-07-21 |