| NPI | 1891913380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: GA 062035) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: SC 40446) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2018-10-05 |