| NPI | 1821204207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: RI DO00851) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 243559) |
| 207W00000X Ophthalmology (Licence: IL 125047344) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-06-23 |