| NPI | 1093332041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: MN 70631) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL TRN30142) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2023-10-06 |