| NPI | 1942244389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: LA 14570R) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: TX M3070) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: AR E-5887) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2017-03-30 |