| NPI | 1912346388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0108X Ophthalmology Uveitis and Ocular Inflammatory Disease (Licence: MI 4301116878) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301103584) |
| 207WX0107X Ophthalmology Retina Specialist (Licence: MI 4301116878) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2021-01-24 |