| NPI | 1518952597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN MD21605) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 21605) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2020-07-09 |