| NPI | 1134120371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IA 23796) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: IA MD-23796) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2025-05-16 |