| NPI | 1578587135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101232470) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 220610) |
| 207W00000X Ophthalmology (Licence: MD D73940) | |
| 207W00000X Ophthalmology (Licence: VA 0101232470) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D73940) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-04-09 |