| NPI | 1629364054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: UT 11363238-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: UT 11363238-1205) |
| 207W00000X Ophthalmology (Licence: IN 01075209B) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NV 19279) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2019-11-21 |