| NPI | 1548294101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A96629) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A96629) |
| 207W00000X Ophthalmology (Licence: MD D0061183) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0061183) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-04-01 |