| NPI | 1851343214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO 0035446) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 0035446) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-03-10 |