| NPI | 1134120868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: TN 34660) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 27826) |
| 207W00000X Ophthalmology (Licence: TX L0391) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2023-03-24 |