| NPI | 1750692703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MI 4301109258) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301109258) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2020-08-26 |