| NPI | 1518164995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35097206) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.097206) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2018-12-04 |