| NPI | 1003105677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MD D0084732) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX Q3944) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2026-03-26 |