| NPI | 1518250398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX T8027) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 60412) |
| 207W00000X Ophthalmology (Licence: AL 31865) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2022-07-28 |