| NPI | 1811125826 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OH 35.121465) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OH 35.121465) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2019-03-19 |