| NPI | 1801274295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: KY 55107) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA MD-46127) |
| 207W00000X Ophthalmology (Licence: KY TP864) | |
| 207WX0107X Ophthalmology Retina Specialist (Licence: IA MD-46127) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2021-03-22 |