| NPI | 1861466427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 03049) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KY 03049) |
| 207W00000X Ophthalmology (Licence: VA 0102202411) | |
| 207W00000X Ophthalmology (Licence: WV 3034) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: WV 3034) | |
| 207W00000X Ophthalmology (Licence: TX M1538) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2017-07-25 |