| NPI | 1730161373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AR E-4462) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR E4462) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2019-10-11 |