| NPI | 1528324662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 57031) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR PG162890) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 51009) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2018-03-13 |