| NPI | 1952565491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA 110896) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 49767) |
| 207W00000X Ophthalmology (Licence: AZ 49767) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2020-05-21 |