| NPI | 1114994704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 10631) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PR 10631) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2025-01-06 |