| NPI | 1851349195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G76091) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 24189) |
| 207W00000X Ophthalmology (Licence: NM MD2014-0974) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM MD2014-0974) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2022-07-21 |