| NPI | 1508819947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD24356) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR MD24356) |
| 207W00000X Ophthalmology (Licence: WA MD00046261) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WA MD00046261) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2017-11-01 |