| NPI | 1942455423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA A116602) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA A116602) |
| 207W00000X Ophthalmology (Licence: OH 093544) | |
| 207W00000X Ophthalmology (Licence: KY 54392) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2022-06-06 |