| NPI | 1689642290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NE 31257) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: IA 23468) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2019-02-03 |