| NPI | 1740443522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: LA MD.202150) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA MD.202150) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2020-10-05 |