| NPI | 1003542101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OK 45401) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: WI 83413-20) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: 230486) | |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2026-04-13 |