| NPI | 1871599100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX j6115) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX j6115) |
| 207W00000X Ophthalmology (Licence: TX j6115) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2017-04-19 |