| NPI | 1669665105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 50891) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TN 50891) |
| 207W00000X Ophthalmology (Licence: KY 47302) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 47302) | |
| Enumeration Date | 2007-08-18 |
| Last Update Date | 2017-08-04 |