| NPI | 1063031508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: TX V9024) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: TX V9024) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-08-04 |