| NPI | 1639172984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.058267) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD042140E) |
| 207W00000X Ophthalmology (Licence: OH 35058267) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: PA MD042140E) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2021-05-11 |