| NPI | 1730421983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OK 33895) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 57.023658) |
| 207W00000X Ophthalmology (Licence: OK 33895) | |
| 207W00000X Ophthalmology (Licence: FL ME131171) | |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-12-17 |