| NPI | 1669436143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 041558) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 041558) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2019-03-08 |