| NPI | 1962622951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD162475) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR LL16656) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-01-08 |