| NPI | 1750328241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: WV 22677) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35097037) |
| 208600000X Surgery (Licence: WV 22677) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2021-05-06 |