| NPI | 1548528821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301117181) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301117181) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2024-04-08 |