| NPI | 1871720755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 50648) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 50648) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2020-05-22 |