| NPI | 1689968216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2017-00467) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: NC 2017-00467) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2021-04-27 |