| NPI | 1619910544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 9929) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN MD009929) |
| 207W00000X Ophthalmology (Licence: AR R4424) | |
| 207W00000X Ophthalmology (Licence: MS 14866) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MS 14866) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: AR R4424) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-01-15 |