| NPI | 1750427555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101244998) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MD D0068656) |
| 207W00000X Ophthalmology (Licence: VA 0101244998) | |
| 207W00000X Ophthalmology (Licence: DC MD37862) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2019-04-09 |