| NPI | 1992182794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: DC MD046964) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN22040) |
| 207W00000X Ophthalmology (Licence: DC MD046964) | |
| 207W00000X Ophthalmology (Licence: MD D0087357) | |
| 207W00000X Ophthalmology (Licence: VA 0101266781) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: VA 0101266781) | |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2020-01-08 |