| NPI | 1922201870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: LA MD.202985) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: LA MD.202985) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-01-15 |