| NPI | 1538361423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 0101242539) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MN 49565) |
| 207W00000X Ophthalmology (Licence: CT 046486) | |
| 207W00000X Ophthalmology (Licence: MD D0069193) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101242539) | |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease (Licence: VA 0101242539) | |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2017-04-17 |