| NPI | 1558381632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WI 30965) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 30965) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-04-07 |