| NPI | 1952487829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist (Licence: AZ 41796) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 41796) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-01-10 |