| NPI | 1902809262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX J5410) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX J5410) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: NM 95-298) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-06-17 |