| NPI | 1962592634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CO 37277) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CO 37277) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-03-30 |