| NPI | 1811218316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA 138518) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: PA Mt194706) |
| 207W00000X Ophthalmology (Licence: NM rs2013-0129) | |
| 207W00000X Ophthalmology (Licence: FL ME118992) | |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2017-04-03 |