| NPI | 1518353168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 325976) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35135633) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35135633) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2021-08-25 |