| NPI | 1144426230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PR 16801) |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist (Licence: PA 16801) |
| 207W00000X Ophthalmology (Licence: PA MD434861) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2022-03-14 |