| NPI | 1942347703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: KY 42434) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NC 2008-00297) |
| 207W00000X Ophthalmology (Licence: KY 42434) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2017-05-09 |