| NPI | 1578791372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: NV 15712) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC LL32028) |
| 207W00000X Ophthalmology (Licence: VA 0101253787) | |
| 208600000X Surgery (Licence: SC LL32028) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2021-03-10 |