| NPI | 1659685063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: SC AL40354) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA MD449668) |
| 207W00000X Ophthalmology (Licence: SC AL40354) | |
| 207W00000X Ophthalmology (Licence: NC 201000956) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2020-10-22 |