| NPI | 1568825222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CT 1.068238) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.138743) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2021-07-19 |