| NPI | 1578761011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 21670) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AR E-7330) |
| 207W00000X Ophthalmology (Licence: TX P5039) | |
| 207W00000X Ophthalmology (Licence: TN MD0000047139) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: AR E7330) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: MS 21670) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: TN 47139) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2023-03-09 |