| NPI | 1912963588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 22740) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 22740) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2019-04-30 |