| NPI | 1861461402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MA 227892) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 218077) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2021-12-20 |