| NPI | 1801848171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MN 49508) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD25646) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-09-21 |