| NPI | 1568648699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2016018569) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: MO 2016018569) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2022-09-14 |